Rx_1.1 Flashcards
How to calculate drug clearance
clearance = rate of drug elimination/plasma drug concentration
Common pulmonary infection in HIV patient
- Pneumocystis jiroveci ==> interstitial pneumonia
Fxn + name of HIV surface proteins
- two imporant envelope proteins:
- gp41
- gp120
- fxn of surface proteins is to bind CD4 receptors ==> envelope fusion and HIV entru into cell
Stage of cell cycle of oocyte from birth to ovulation
prophase I
Oocyte cell cycle from ovulation ==> embryo
- at birth: all oocytes arrested in meiosis I (prophase I)
- after ovulation: oocye progresses through miosis I ==> metaphase II
- oocyte is arrested in metaphase II until fertilization
- after fertilization: oocyte completes meiosis II and begins mitotic growth of embryo
Lead impact on heme synthesis
- Lead inhibitions ALA dehydratase and ferrochelatase
- ALA dehydratase mediates conversion of ALA to porphobilinogen
- ferrochelatase incorporates iron into protoporphyrin IX (final step in heme synthesis)
Tx w/penicillins, sulfonamides followed by fatigue, temp + erythematous macules/papules + burning sensation ==> Dx?
- Stevens-Johnson syndrome (acute epidermal disorder)
- urticaria-erythema multiforme-toxic epidermal necrolysis
Drugs that ==> Stevens-Johnson syndrome
- penicillins
- sulfonamides
- ethosuximide (anticonvulsant: absence/epileptic seizures)
- lamotrigine (anti-epileptic; mood stabilizer)
Dx?
- interstitial pneumonia
- most likely p. jiroveci
Tx of Pneumocystitis jiroveci pneumonia (+ MOA)
- trimethoprim-sulfamethoxazole
- MOA = inhibitis bacterial folate synthesis via inhibition:
- dihydropteroate synthetase (trimetho) and dihydrofolate reductase (sulfa)
Characteristics of H. pylori
- gram -
- flagellated
- oxidase +
- helical organism
- produces urease
- most common cause of gastric ulcers
- classic = antral ulcer with regular, rounded edges and smooth base
p53 gene fxn
- p53 = tumor suppressor gene
- activated by DNA damage due to chemical insult, oxidate stress, UV radiation ==>
- arrest of cell cycle progression
- DNA repair
- apoptosis
location of p53 gene
chromosome 17
Consequences of loss of p53 gene
- neoplasm:
- lung
- breast
- colon
- Li-Fraumeni syndrome
diagnostic criteria for Li-Fraumeni syndrome
- age < 45 yrs
- first-degree relative w/cancer @ <45 yrs
- another first or second-degree relative w/cancer @ <45 yrs or sarcoma at any age
Celiac artery supplies blood to ….?
- celiac ==> L gastric, splenic, common
- foregut structures
- stomach
- proximal duodenum
- liver
- gallbladder
- pancreas
- spleen
fever + runny nose + bilateral cervical lymph nodes ==> Dx?
Corynebacterium diptheria infection
MOA of diptheria toxin
- adenosine diphosphate ribosylation of elongation factor 2 ==>
- inhibtion of protein syntehsis in animal cells ==> cell death
Consequence of 21-alpha-hydroxylase deficiency
unable to synthesize mineralocorticoids ==> chronically elevated renin levels
Pathophysiology of osteogenesis imperfect
- defect in type 1 collagen
- type 1 collagen production is decreased due to inability of pro-alpha chain mRNA to be translated into polypeptides
Mutations in Type 1 osteogenesis imperfecta
- COL1A1 or COL1A2 (encorde alpha1 and alpha2 collagen chains)
- ==> inability of mRNA to be translated
Pathologic finding?
- Heinz bodies = hemoglobin inclusions w/in red blood cell
- common in hemolytic anemia
Presentation of G6PD
- previously health patient
- common in people of African or Mediterranean origin
- development of hemolytic anemia after treatment for bacterial infection
